The primary objective of this study was to determine the role of picornavirus in flu-like episodes (temperature of > or =38.0 degrees C plus one respiratory and one constitutional symptom) among otherwise healthy adults enrolled in a placebo-controlled, double-blind, randomized oseltamivir treatment study. Combined nasal and pharyngeal swabs were collected at baseline for influenza cultures and picornavirus reverse transcription (RT)-PCR. In addition, acute- and convalescent-serum samples were obtained for serological studies of common respiratory pathogens. From a total of 719 subjects enrolled in the clinical trial within 36 h of the onset of symptoms, 475 (66%) had evidence of recent influenza A or B virus infections by means of culture and/or serological testing. Of the 244 remaining patients, 36 (15%) presented a seroconversion for at least one of the common respiratory viruses or atypical pathogens. An RT-PCR assay for the picornavirus 5" noncoding region (NCR) was positive in a subset of 15 (19%) of 78 patients with flu-like illnesses of undetermined etiology. Sequence analysis of the picornavirus 5" NCR amplicons revealed that 14 (93%) of them had greater homology to rhinoviruses, whereas 1 (7%) was related to enteroviruses. Interestingly, median total symptom scores and oral temperatures of picornavirus-positive patients (n = 15) and placebo-treated influenza virus-positive patients (n = 161) were similar over a 3-week period. We conclude that, among the influenza virus-negative preselected cases of this study, rhinoviruses were relatively frequent pathogens associated with important respiratory and systemic symptoms.

Acetamides/*therapeutic use, Adolescent, Adult, Aged, Antiviral Agents/*therapeutic use, Double-Blind Method, Enterovirus/classification/*isolation & purification, Humans, Influenza A virus/isolation & purification, Influenza B virus/isolation & purification, Influenza, Human/*drug therapy/*virology, Middle aged, Nasopharynx/virology, Picornaviridae Infections/*virology, RNA, Viral/blood, Rhinovirus/classification/*isolation & purification
Journal of Clinical Microbiology
Erasmus MC: University Medical Center Rotterdam

Boivin, G, Gaudreau, A, Jackson, H.C, Groen, J, Ward, P, & Osterhaus, A.D.M.E. (2002). Role of picornaviruses in flu-like illnesses of adults enrolled in an oseltamivir treatment study who had no evidence of influenza virus infection. Journal of Clinical Microbiology. Retrieved from